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Anthem Veteran (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Anthem Veteran (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Anthem Veteran (PPO) in 2025, please refer to our full plan details page.
Anthem Veteran (PPO) is a PPO plan offered by Elevance Health, Inc. available for enrollment in 2025 to people living in Select counties in Missouri. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that Anthem Veteran (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Anthem Veteran (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Anthem Veteran (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $70.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $10000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $10000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Anthem Veteran (PPO)
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Drug Coverage
Prescription drugs are not covered by Anthem Veteran (PPO).
Additional Benefits
The Anthem Veteran (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, while outpatient services range from no copay to $275. Emergency services, primary care visits, preventive services, hearing and vision exams, and dental services offer coverage with copays. The plan also includes coverage for ambulance, transportation, and home health services with no copay. Additional benefits include over-the-counter items, and meals with no copay. However, services like cardiac rehabilitation and certain other specialized services may not be covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $360 copay for days 1-5, and no copay for days 6-90; for Inpatient Hospital Psychiatric, you pay a $295 copay for days 1-6, and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are covered with no copay. Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered, as is Non-Medicare-covered Stay for Inpatient Hospital Psychiatric.
Outpatient Services See details
Outpatient services include coverage for all outpatient hospital services, observation services, ambulatory surgical center (ASC) services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay ranging from $0 to $275, observation services have a $275 copay, ASC services have no copay, outpatient substance abuse individual and group sessions have a $45 copay, and outpatient blood services have no copay.
Partial Hospitalization See details
Partial Hospitalization is covered under the Anthem Veteran (PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with no coinsurance for any services. Ground and Air Ambulance Services have a $290 copay, while Transportation Services to a Plan Approved Health-related Location have no copay, but only covers 60 one-way trips per year by rideshare, bus/subway, van, or medical transport. Transportation Services to Any Health-related Location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Anthem Veteran (PPO) plan. Emergency Services and Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation each have a $90 copay, while Urgently Needed Services has a $25 copay; all services have no coinsurance.
Primary Care See details
The Anthem Veteran (PPO) plan covers primary care physician services with no copay, chiropractic services with a $15 copay, occupational therapy services with a $35 copay, physician specialist services with a $45 copay, mental health specialty services with a $40 copay for individual and group sessions, podiatry services with a $0-$45 copay, other health care professional services with a $0-$20 copay, psychiatric services with a $40 copay for individual and group sessions, physical therapy and speech-language pathology services with a $35 copay, additional telehealth benefits with no copay, and opioid treatment program services with a $45 copay. Routine chiropractic care is not covered.
Preventive Services See details
The Anthem Veteran (PPO) plan covers preventive services, including an annual physical exam with no copay. Additional preventive services, like Fitness Benefit, Remote Access Technologies, and Home and Bathroom Safety Devices, are covered, but may have a copay. Other services like Health Education, In-Home Safety Assessment, and Medical Nutrition Therapy are not covered.
Hearing Services See details
Hearing Services includes hearing exams with a $45 copay, routine hearing exams with no copay, and fitting/evaluation for hearing aids with no copay. Prescription hearing aids are covered with a maximum benefit of $2000 per year, while OTC hearing aids are covered with no copay and a maximum benefit of $300 per year.
Vision Services See details
Anthem Veteran (PPO) covers vision services, including eye exams with a copay between $0 and $45. Eyewear is covered with no copay, and a combined maximum of $200 per year for contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames.
Dental Services See details
Dental services are covered, with a $2,000 annual maximum benefit for both in-network and out-of-network services. Preventive, diagnostic, restorative, and surgical dental services are covered with no copay.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Anthem Veteran (PPO) plan, and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the Anthem Veteran (PPO) plan with a coinsurance of 20%.
Medical Equipment See details
Medical equipment benefits include Durable Medical Equipment (DME) with 0% to 20% coinsurance, Prosthetic Devices with 20% coinsurance, and Medical Supplies with 20% coinsurance. Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts have no copay, and Diabetic Equipment has a copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, with a copay for Medicare-covered diagnostic procedures, tests, and lab services, with a minimum copay of $0 and a maximum copay of $100. Lab services have no copay. Diagnostic Radiological Services have a copay that is at most $275, with a minimum copay of $50. Therapeutic Radiological Services have a coinsurance of at least 20%. Outpatient X-Ray Services have a $50 copay.
Home Health Services See details
Home Health Services are covered by the Anthem Veteran (PPO) plan with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Anthem Veteran (PPO) plan. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered by the Anthem Veteran (PPO) plan. For days 1-20, there is no copay, and for days 21-100, the copay is $203.
Other Services See details
The Anthem Veteran (PPO) plan covers over-the-counter (OTC) items with no copay, and a maximum plan benefit coverage amount of $75 every three months. The plan also covers meal benefits with no copay, and other services with no copay. However, acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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